Abstract
This paper explains that, whereas other industries afflicted by high premiums have shifted some of this burden to the customer by increasing the fees charged, this is generally not an option for the LTC industry because the great majority of patients in nursing homes have their costs paid by federal Medicare and Medicaid programs. The author points out that the high costs of the litigious climate are causing some states, such as Florida and Texas, to implement damage award caps. The paper stresses that the goal of preventing abuse and increasing the standards of care in long-term facilities is being thwarted by a system that pits lawyers against nursing homes.

From the Paper
"The long-term care homes were the most profitable sector in the late 1980s, Fletcher writes, but are now the least profitable for the insurance industry. Losses are so extreme in the nursing home sector that many carriers are refusing to insure long-term facilities. Fletcher mentions two states, Florida and Texas that are hit particularly hard by insurance carrier losses. At the root of these skyrocketing premiums is the different legal climate that has awarded large settlements to plaintiffs in suits against LTC facilities."

Tags:arbitration, tort, litigious, federal, abuse

Abstract
This paper explains that tort reform, putting a cap on jury awards in malpractice suits, is exactly what the insurers want because, in addition to making a handsome profit on their medical malpractice lines as it stands, they would then have to pay out even less. The author points out that reducing consumer health insurance costs would be better served by a systematic effort to weed out bad doctors and prevent malpractice. The paper stresses that, even if there were a link between medical malpractice insurance costs and consumer health insurance costs, the culprit is the insurer itself because it is not allowed, by law, to raise rates in response to big payouts; insurers are allowed to raise rates when their projected investment income declines.

From the Paper
"The suggestive portion of the NAIC findings is this: although malpractice insurance premiums make up such a small portion of health-care costs, medical malpractice as a line of insurance demonstrated the highest profit as a percentage of premiums (Stewart, 21+), making it very lucrative for the insurance companies. Further, losses paid by those insurers in 1991 came to only about 31 cents of every $100 of health care costs; remember, malpractice premiums accounted for 64 cents per $100 spent, leaving 33 cents for the company out of each $100. While the amount spent on malpractice insurance by the consumer, trough his or her medical expenditures, is negligible, there are a lot of people spending $100 frequently, massing up piles of 33 cents for the insurers."

Tags:insurer, premiums, costs, cap, profit

Abstract
This paper explains that the main reason why caps should exist on malpractice suit is the cost of malpractice insurance for doctors, which has forced many doctors to stop practicing medicine. The author points out that placing caps on malpractice awards might shield negligent doctors from being held accountable for their mistakes and might prevent patients from getting the monetary awards that match the economic and traumatic impact of the injuries they have incurred. The paper states that the solution to this issue is to place caps on malpractice awards; however, in extreme cases where negligence is apparent and the impact of such negligence is irrevocable, there must be exceptions to such caps.

Table of Contents
Introduction
Why Caps on Malpractice Awards
Why No Caps on Malpractice Awards
Discussion and Conclusion

From the Paper
"The problems associated with malpractice awards came to the forefront in 2002 when a group of 60 specialists at the University Medical Center in Las Vegas refused to work because of the high cost of malpractice insurance. Their actions caused the hospitals emergency room to shut down. This gave Nevada and the nation a glimpse of the public health crisis that could ensue if caps are not placed on Malpractice Awards. In the case of Las Vegas, legislatures came together and placed a $350,000 cap on the amount of money that a patient could receive as a non economic award in a malpractice case. However, lawmakers did attach to exceptions to the bill including "one involving cases where there is "gross malpractice". The other where there is "clear and convincing" evidence that an award should exceed the $350,000 cap."

Tags:cost, specialists, accountable, irrevocable, premiums

Abstract
This paper critically evaluates the statutes purposely passed to tackle medicare and medicaid insurance fraud. It also examines the fundamentals, penalties, defenses, and safe harbor provisions for each and every statute, as well as concludes with a discussion of accessible legal safe harbor provisions. It discusses the wide-ranging federal statutes employed to impeach health care fraud, together with the False Claims, False Statements, and the Mail and Wire Fraud Acts, and explains the basics of the offenses, accessible defenses, and penalties valid under each statute. It also gives an indication of federal and state government agencies' pains to examine and take legal action against health care fraud.

Outline
Introduction
Statutes and Provisions Specifically Enacted to Address Medicare and Medicaid Fraud
Medicaid False Claims Statute
Penalties
Medicaid Anti-Kickback Statute
Sale of Physician Practices, Practitioner Recruitment and Obstetrical Malpractice Insurance Subsidies
Contracts for Space, Equipment, Personal Services and Employment
Advertisements and Promotions
Referral Services
Relationships Between Providers
Arrangements Between Providers and Health Plans
Relationships Between Providers and Suppliers
Prosecuting Health Care Fraud With General Federal Statutes
False Claims Act
False Statements
Mail and Wire Fraud
Conclusion

From the Paper
"An added safe harbor permits health plans with accords with CMS or a state health care program to give care for beneficiaries to augment coverage, decrease cost sharing amounts, or decrease premium amounts for enrollees under particular conditions. If the proposal is a competitive medical plan, health maintenance organization plan, prepaid health plan or any other plan with a contract with CMS or a state health care program, it has got to offer identical augmented coverage or reduced cost-sharing or payments to all Medicare or state health program enrollees unless CMS or the state endorses otherwise."

Tags:federal, statutes, false, claims, statements

Abstract
This paper critically evaluates the statutes purposely passed to tackle Medicare and Medicaid insurance fraud. It evaluates the fundamentals, penalties, defenses, and safe harbor provisions for each and every statute, and concludes with a discussion of accessible legal safe harbor provisions. It discusses the wide-ranging federal statutes employed to impeach health care fraud, together with the False Claims, False Statements, and Mail and Wire Fraud Acts and explains the basics of the offenses, accessible defenses, and penalties valid under each statute. It also gives an indication of federal and state government agencies' pains to examine and take legal action against health care fraud.

Outline
Introduction
Statutes and Provisions Specifically Enacted to Address Medicare and Medicaid Fraud
Sale of Physician Practices, Practitioner Recruitment and Obstetrical Malpractice Insurance Subsidies
Contracts for Space, Equipment, Personal Services and Employment
Advertisements and Promotions
Referral Services
Relationships Between Providers
Arrangements Between Providers and Health Plans
Relationships Between Providers and Suppliers
Prosecuting Health Care Fraud with General Federal Statutes
Conclusion

From the Paper
"Individuals and organizations licensed by Department of Health and Human Services ("HHS") to accept imbursement under the Social Security Act may focus on Medicare and Medicaid fraud examinations (7). Persons, as well as organizations comprise nursing and rehabilitation centers, hospitals, Health Maintenance Organizations ("HMOs"), intermediate carriers for example private and public clinics, private insurance companies, durable medical equipment ("DME") providers, medical laboratories, physician practice groups, physicians, as well as other certified health care organizations (7)."

Tags:statute, false, claims, providers, referral, suppliers

Abstract
This paper explains that the FDA and numerous other organizations report that prescriptions drugs cause an enormous number of preventable injuries and death resulting in "cap" laws, a rise in insurance costs, regulations on physicians and the death of innumerable innocent civilians. The author points out that, on the other hand, the non-partisan Congressional Budget Office finds that the costs associated with malpractice-buying insurance and paying out damage awards-amounts to less than two percent of America's skyrocketing healthcare expenses. The paper stresses that the problem of malpractice will not cease without the help of well trained doctors, honest and just politicians and insurance workers who value their customers.

From the Paper
"In light of numerous large payouts associated with medical malpractice, President George W. Bush called for strict limits on medical malpractice suits, including a "cap of $250,000 on what victims and their families could recover for non-economic damages." He also inflicted an attack on lawyers fees, including a drop from thirty percent, to twenty on cases less than 600K. On cases exceeding 600K, he dropped twenty percent to fifteen percent. Now, let's look more in-depth. When taking on a malpractice suit, it immediately throws the victim and lawyer into a David and Goliath situation, and in light of Bush's bill, "David has lost his sling.""

Tags:suits, doctors, insurance, costs, pharmacy

Abstract
The paper reveals the high cost of medical malpractice litigation that drives insurance costs and premiums higher and ultimately results in higher costs for consumers. The paper also discusses how malpractice litigation results in physicians offering less healthcare options and less access to medical care for many. The paper therefore argues that a reform of the present system is desirable from the viewpoint of all stakeholders to include medical services providers and physicians, the patients, and the nation's courtrooms that are presently heavily laden with medical malpractice litigation. This paper contains a figure

Outline:
Objective
Introduction
Literature Review
Analysis and Discussion
Conclusion

From the Paper
"Medical malpractice and liability has resulted in a great deluge of lawsuits in the courts of the United States and while it is necessary that these reprises exist for the purpose of ensuring the quality of delivered healthcare services, simultaneously, medical malpractice and liability concerns also result in the hesitation of medical professionals to try new or alternative treatments which might well be more effective and less costly and drives the expanding costs of insurance to cover medical professionals in the event there is some medical malpractice or liability incurred during the course of the medical practice which effectively drives up the cost of medical services for the consumer."

Tags:insurance, premiums, tort, lawsuits, patients

Abstract
This paper takes a look at the global problem of medical malpractice and examines the issues and objectives concerning the development and enforcement of policies that would limit malpractice awards. The paper also recommends a set of objectives, options and actions that nurses and others can actively take to reduce their risk.

Table of Contents
Abstracts
Caps on Medical Malpractice Awards
Background
Issue Statement
Stakeholders
Policy Objectives
Policy Alternatives
Summary -- Recommended Policy

From the Paper
"That malpractice is an industry cannot be denied. Attorneys, professional lobbying agents and agencies wine and dine politicians for their cause. The media follows every move. People are employed and significant money flows through the economy all due to the increase in malpractice suits and the amount of awards. There are a number of factions that comprise the growth of the malpractice industry and have significantly affected its development including social, economic, ethical, political and legal factors."

Tags:insurance, premium, rates, doctors, practitioners, pain, suffering, compromising, healthcare

Abstract
This paper explains how medical malpractice occurs, and explains why reform regarding medical malpractice laws is absolutely necessary. The author puts a lot of his own personal observations and views into the paper and explains why people find it hard to file a lawsuit against a doctor simply because they cannot find a lawyer who is willing to take on their case.

From the Paper
''Medical malpractice occurs when there has been professional negligence from a specialist or doctors in general, also including nurses and others whom may work directly or indirectly with the patient. Unfortunately as medicine is a ``practice'', errors naturally occur. However, there is also many times where the errors are caused by the neglect of another. ''Between 44,000 to 98,000 Americans die in hospitals each year due to preventable medical errors; Even using the lower estimate, preventable medical errors in hospitals exceed attributable deaths to such feared threats as motor-vehicle wrecks, breast cancer, and AIDS'' (IOM, 1999). Those statistics are alarming and the key word here is ''preventable''.
Large settlements from medical malpractice lawsuits directly impacts medical malpractice insurance rates. This problem has had much to do with individual states instituting cap laws to protect insurance companies and physicians alike from erroneous lawsuits. Although the intended purpose may be helping avoid such lawsuits, in turn it is creating a major problem in the quality of patient care.''

Tags:insurance, malpractice, patient

Abstract
This paper looks at the commonalities between American and British cases of medical malpractice. The paper notes that the major points of similarity of both countries tends to be the legal system's hands-off attitude toward physicians and an unwillingness for some of the judiciary in both places to take control, even when the issue of responsibility is placed before them. The paper also looks at what has caused the general decline in the health care systems of both countries and the current push for reform being seen in both countries.

From the Paper
"In the case of Elam v. College Park Hospital, Elam had originally complained that her podiatrist had performed negligent podiatric surgery at College Park Hospital to correct bilateral bunions and bilateral hammer toes, despite the hospital's co-admission procedure, requiring a hospital doctor to assume responsibility for the overall medical care of each patient. But a California appeals court reversed a lower court decision that had found for the defendant, College Park Hospital. Ruling on June 25, 1982, California's Fourth Appellate Court noted that the original case revolved around "whether a hospital is liable to a patient under the doctrine of corporate negligence" when independent surgeons who are staff members use hospital facilities."

Tags:universal, coverage, u.s., u.k., insurance, podiatrist, negligent, hospital, procedure